Challenges in treatment of a patient suffering from neuroendocrine tumor G1 of the hilar bile duct: a case report

Abstract

Background Neuroendocrine tumors (NETs) arise from neuroendocrine cells and are extremely rare in the biliary tract. Currently, there are no guidelines for the diagnosis and treatment of biliary NETs. We presented a case with NETs G1 of the hilar bile duct and the challenges for her treatment. Case presentation A 24-year-old woman was presented to our department with painless jaundice and pruritus, and the preoperative diagnosis was Bismuth type II hilar cholangiocarcinoma. She underwent Roux-en-Y hepaticojejunostomy with excision of the extrahepatic biliary tree and radical lymphadenectomy. Unexpectedly, postoperative pathological and immunohistochemical examination indicated a perihilar bile duct NETs G1 with the microscopic invasion of the resected right hepatic duct. Then the patient received 3 cycles of adjuvant chemotherapy (Gemcitabine and tegafur-gimeracil-oteracil potassium capsule). At present, this patient has been following up for 24 months without recurrence or disease progression. Conclusion We know little of biliary NETs because of its rarity. There are currently no guidelines for the diagnosis and treatment of biliary NETs. We reported a case of perihilar bile duct NETs G1 with R1 resection, as far as we know this is the first report. More information about biliary NETs should be registered.

Primary perihilar bile duct neuroendocrine tumor: a case report and review of the literature

“…In this instance, the patient's preoperative tumor markers were within the normal range, which corroborates this standpoint. However, for patients with B-NET G3 stage and B-NECs, CA19-9 and CA125 levels often exceed normal levels [12]. Serum CgA, Syn, and neuron-specific enolase (NSE) demonstrate a relatively high positivity rate in NENs, providing a certain diagnostic value.…”

Inovações adotadas no diagnóstico de tumores neuroendócrinos do intestino delgado

“…Sua incidência progrediu de 1,09/100.000 em 1973 para 6,98/100.000 em 2012. TNEs surgem principalmente no trato gastrointestinal (45,2%), sistema respiratório (30,2%) e pâncreas (15,3%) (Zhang et al, 2022). São divididos em dois grupos, os bem e moderadamente diferenciados, também nomeados tumores neuroendócrinos verdadeiros, e os pouco diferenciados, os carcinomas neuroendócrinos.…”